Membership Levels

Platinum Membership: $1,000.00 (Includes full year membership and two (2)
annual conference registrations—1 doctor, 1 staff member 1 payment of $1,000 or 12 monthly payments of $83.33.
Click Here for Monthly Payment Option

Annual Membership: $400

Spouse Membership: $200
must be spouse of a paid $400+ membership

Student / First Year Graduate: FREE

Membership Type(Required)

Name(Required)

First Last

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Office Phone(Required)

Cell or Home Phone

WY License Number(Required)

In Practice Since(Required)

Chiropractic School Attended

Website(Required)

Facebook page (clinic or personal)

I am interested in volunteering for WCA committees, projects or board service(Required)

Yes

No

As a member, I elect to contribute $25 of my dues to the WCA PAC (Political Action Committee)

Yes

Additional WCA PAC Contribution

Additional PAC Contribution Amount

Total

Payment Method